India, the second most populous country in the world, has a major problem with Iodine deficiency. It is estimated that 150 million people in the country are afflicted with Iodine Deficiency Disorders (IDD).
Goitre, an enlargement of the thyroid gland that is commonly visible as a swelling of the anterior part of the neck, is most commonly associated with IDD. However, in addition to goitre, IDD is also linked to cretinism, neurological defects, stunted growth, stillbirths, and reproductive failure.
To tackle this problem, India's National Goiter Control Program was launched in 1962 with iodisation of salt as its primary strategy for control of IDD. Iodised salt is considered to be the most economical, convenient and effective way of treating IDD.
This led to a ban on the sale of normal or common salt, in favour of iodised salt, in 1998.
There are two ways of iodising salt: adding Potassium Iodide (KI); or adding Potassium Iodate (KIO3). The iodised salt sold in India contains the chemically much more stable of the two; Potassium Iodate.
Many of India's local salt producers lack the technology or determination to manufacture iodised salt, resulting in the need for it to be imported; mainly from the USA.
The safety of iodised salt
Iodised salt is considered to be safe. Ingesting an excess rarely causes problems; the excess is excreted from the body. People suffering from Grave's Disease are less tolerant of Iodine; as are those who have suffered Iodine deficiency in the past, although they are easy to treat if they develop hyperthyroidism.
Iodised salt has increasingly become a medium for combating Iodine deficiency in India. UNICEF and the World Health Organization have spearheaded efforts to iodise salt as the simplest and most effective way to make up for Iodine deficiencies.
Opposition to iodised salt
A Hindu nationalist party, Swadeshi Jagran Manch (SJM) also known as the National Awakening Front, has vehemently opposed the use of iodised salt in India. SJM believes that the compulsory use of iodised salt in India is the result of a multinational corporate conspiracy.
Salt has long been a contentious issue in India. During the days of British rule, all salt production and sale was controlled by the British and a salt-tax was imposed to raise revenue to support the Raj; forcing the poor to buy salt they could not really afford. It was a criminal offence for Indians to produce their own salt.
In March 1930, Mahatma Gandhi, in an act of peaceful, civil disobedience, started what became known as the "The Gandhi Salt March" or the "March to Dandi". Gandhi and his supporters marched from Sabarmati to the coastal village of Dandi: a journey of 240 miles. Gandhi encouraged his thousands of followers to make salt wherever it "was most convenient and comfortable" to them.
After Gandhi's march thousands of people produced salt, or bought illegal salt. The Dandi salt march was a key turning point in the struggle for India's independence from British rule.
SJM have recalled that the right to use common salt, freely available on sea coasts, was an issue Gandhi highlighted in India's movement for independence from British colonial rule. The idea being to make a link between oppressive colonial rule and oppressive control by multinational corporations: the fallacy of the argument being that multinational corporations are exacting oppressive control. The ban on salt was imposed by the Indian government; for health reasons.
SJM is opposed to the use of iodised salt despite its medically-based support from doctors and the health care community. This is because SJM strives for India's self-reliance through Hindu nationalism, and the protectionism of its industries: it considers India a nation enslaved by the global marketplace which is destroying its morals, and contaminating its market.
In September 2000 the Prime Minister of India, Atal Bihari Vajpayee, despite protests from doctors who said it will expose a large section of people to the risk of Iodine deficiency, overturned the ban on the sale of common salt. This decision was reached after much pressure from SJM, which has members in India's parliament.
SJM claimed that the IDD epidemic is nothing more than:
- a western conspiracy
- a non-issue for the Indian government.
- iodised salt is six times the cost of normal salt.
- the efficacy is lost due to high temperature cooking.
- using it can leave the user vulnerable to TB, diabetes, cancer, and peevishness.
IDD has a long history, not only in India, but also much of Asia. The cause is a low concentration of Iodine in the soils, especially in the higher regions. This was true long before the west industrialised, and a global economy emerged.
The government has been concerned with IDD for many years, especially since it was proven that it is caused by an Iodine deficiency and is potentially easy to treat.
The cost of iodised salt is only fractionally higher than common salt. Of course, in a poor country, that may be enough to encourage people away from iodised salt, and that was one reason why the ban was imposed.
Much Indian cooking is done at high temperature using cooking oil. SJM claimed that iodised salt loses its potency when used in this way. It is probably basing its assumption on Potassium Iodide, which can lose potency this way. Iodised salt sold in India is Potassium Iodate; a much more stable compound, which is not affected by high temperature cooking.
As for the health-vulnerability claims, there does not appear to be any basis for them other than the incorrect idea that an excess of Iodine intake is harmful. They are exaggerations entirely without foundation.
Having made progress in the battle against IDD, the Indian government took the retrograde step of lifting the ban on the sale of common salt. This step was taken based on SJM's irrational fear of a corporate conspiracy, and multinationlism.
The premise for lifting the ban was "free choice" for the consumer: consumers who are largely uneducated and illiterate.
The consequences for the people of India are obvious: they are likely to see an increase in IDD and the suffering that goes along with them. In such a populous country, that means millions could suffer.
A public health policy has been influenced by a conspiracy theory, based on fervent nationalism and an irrational fear of multinational corporations: in spite of scientific evidence.